Reporting Methods

Method 1: E-Mail

In the Subject Line you MUST have: Montgomery County Self Ins Property

In the body of the e-mail, include the standard report information above

Provide your name and phone number

Method 2: Fax

Fax the report to 866-777-1668 via the Network. If reporting by fax, please include the fax cover sheet. Download Liability Fax Cover Sheet. Make sure the items you are faxing are clear and legible. The first report representative will receive your fax and submit the results electronically to the handling MCSIP claim office.

Method 3: Telephonic

Call 888-606-2562. The phone will be automatically answered “Montgomery County Self Insurance Program, first report of injury.” A telephonic first report representative will receive your call and prompt you through the questions necessary to complete the report.